How To Use HCPCS Code C9485

HCPCS code C9485 describes the injection of olaratumab, with a dosage of 10 mg. This code is used to identify and bill for this specific medical procedure. In this article, we will explore the details of HCPCS code C9485, including its official description, procedure, when to use it, billing guidelines, historical information, and Medicare and insurance coverage.

1. What is HCPCS C9485?

HCPCS code C9485 is a specific code used to identify the injection of olaratumab, with a dosage of 10 mg. It is important for medical coders to accurately assign this code when billing for this particular procedure.

2. Official Description

The official description of HCPCS code C9485 is “Injection, olaratumab, 10 mg.” This description clearly indicates the specific medication and dosage involved in the procedure. The short description for this code is “Enteral supp not otherwise c,” which provides additional information about the nature of the procedure.

3. Procedure

1. Prepare the olaratumab injection according to the manufacturer’s instructions.
2. Ensure that the patient is in a suitable position for the injection.
3. Cleanse the injection site with an appropriate antiseptic solution.
4. Using a sterile syringe and needle, withdraw the prescribed dosage of olaratumab from the vial.
5. Administer the injection into the patient’s subcutaneous tissue or muscle, following proper injection techniques.
6. Dispose of the used syringe and needle in a sharps container.
7. Document the procedure in the patient’s medical record, including the dosage administered and any relevant details.

4. When to use HCPCS code C9485

HCPCS code C9485 should be used when performing the injection of olaratumab with a dosage of 10 mg. It is important to ensure that the patient meets the specific eligibility criteria for receiving this medication. The use of this code should be supported by appropriate medical documentation and indications for the procedure.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9485, healthcare providers should ensure that the following documentation requirements are met:

• Medical record documentation supporting the need for the olaratumab injection
• Documentation of the dosage administered
• Documentation of the injection site
• Any additional relevant details or indications

Providers should follow the appropriate billing guidelines and submit the claim with the necessary supporting documentation to ensure accurate and timely reimbursement.

6. Historical Information and Code Maintenance

HCPCS code C9485 was added to the Healthcare Common Procedure Coding System on January 1, 1985. It has an action effective date of January 1, 1996. The code has a pricing indicator code of 57, which indicates that it is priced by other carriers. The multiple pricing indicator code for this code is A, which means it is not applicable as HCPCS priced under one methodology.

It is important to note that HCPCS code C9485 was terminated on December 31, 2017. This means that it is no longer actively used for billing purposes.

7. Medicare and Insurance Coverage

HCPCS code C9485 may have specific coverage instructions that apply, as indicated by the coverage code D. It is important to review the specific coverage guidelines provided by Medicare or other insurance carriers to determine the reimbursement eligibility for this procedure.

8. Examples

Here are five examples of scenarios where HCPCS code C9485 may be billed:

1. A patient with a diagnosed condition that requires the administration of olaratumab as part of their treatment plan.
2. A patient receiving olaratumab as part of a clinical trial or research study.
3. A patient undergoing a specific medical procedure that necessitates the use of olaratumab for optimal outcomes.
4. A patient with a documented medical history of a condition that is known to respond well to olaratumab therapy.
5. A patient with a previously failed treatment regimen who is now being prescribed olaratumab as an alternative therapy option.